MEDICARE: JEFFREY DAVID GARBERICH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1013999267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY DAVID GARBERICH PA-C

Provider Business Mailing Address
First Line	:	3402 SPINNAKER LN
Second Line	:
City	:	BELTON
State	:	TX
Zip	:	76513-2589
Country	:	US
Telephone Number	:	254-217-3482
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 E CENTRAL TEXAS EXPY STE 1260
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-2787
Country	:	US
Telephone Number	:	254-781-8169
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	11/09/2016

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